Advantages of Nutrition Programs

Nutrition directly impacts nearly every aspect of physical and mental health. A healthy diet can help protect against such conditions as heart disease, diabetes, arthritis, stroke, certain cancers and depression. Obesity, which is among the most common conditions linked to diet, affects a record number of Americans.

The American Journal of Health Promotion estimates the cost of obesity to U.S. organization to exceed $12.5 billion in health care, sick leave, and life and disability insurance. Further, one research study reports that obesity raises health care costs by 36% and medication costs by 77%. To offset the health risks of obesity and poor diet, many corporations have committed to helping workers ensure proper nutrition and undertake weight control initiatives.

Popular nutrition initiatives:

Fruit and Vegetable Consumption
1. Provide healthy eating reminders and prompts to workers via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).
2. Provide appealing, low-cost fruits and vegetables in snack machines and in the cafeteria.
3. Provide cookbooks, food preparation, and cooking classes for workers’ families.
4. Ensure onsite cafeterias follow healthy cooking practices and set nutritional standards for foods served that align with the U.S. Dietary Guidelines for Americans.
5. Provide healthy foods at meetings, conferences, and catered events.
6. Use point-of-decision prompts as a marketing technique to promote healthier choices.
7. Provide healthy cooking demonstrations that teach skills (i.e. fruit and vegetable selection and preparation).
8. Provide taste-testing opportunities at the worksite.
9. Provide worker-led campaigns, demonstrations or programs.
10. Provide local fruits and vegetables at the worksite (i.e. worksite farmer’s market or community-supported agriculture drop-off point).
11. Use competitive pricing (price non-nutritious foods in snack machines and cafeterias at higher prices).
12. Provide protected time and dedicated space away from the work area for breaks and lunch.
13. Make kitchen equipment available to workers.
14. Provide an opportunity for onsite gardening if possible.

Sweetened Beverage Consumption
1. Make water available throughout the day.
2. Provide appealing, low-cost healthful drink options in snack machines and the cafeteria.
3. Modify worksite snack contracts to increase the number of healthy options.

4. Price non-nutritious beverages at a higher cost.
5. Use point-of-decision prompts to promote healthier choices.

Portion Control
1. Label foods to show serving size and/or nutritional content.
2. Provide food models, food scales for weighing and pictures to help workers assess portion size.
3. Provide appropriate portion sizes at meetings, worksite events and in the cafeteria.

Nutrition initiatives in action

While many corporations address weight management through fitness initiatives, corporations are increasingly focusing on nutrition through separate programming. Recognizing the productivity boost and lowered medical expenditures that come with maintaining a healthy weight, many corporations may help pay for obesity treatments for workers. For example, to improve the health of dangerously obese workers, drug maker Wyeth reportedly pays for stomach-shrinking surgeries that carry price tags of up to $40,000.

A 2003 Society of Human Resource Management research study shows that 24% of corporations offer weight loss initiatives. In Ohio, Honda offers an onsite, registered dietitian who provides individual or group consultations on weight management. Body fat analysis and body mass index (BMI) measurements are available to workers at any time.

At Grange Insurance’s Columbus headquarters, the cafeteria chef analyzes meals and provides workers basic nutrition information, including Weight Watchers points. Many corporations partner with the American Cancer Society to offer nutrition information through the ”5-ADay” program, which provides corporations free signage and educational materials about the importance of eating five servings of fruits and vegetables a day. The program also offers a fruit and vegetable ”frequency card” that gives workers a free portion of fruit or vegetables after he or she has purchased a preset number.

Wellness programming means different things to different corporations. Effective wellness initiatives can be as simple as bringing bushel baskets of fresh fruit into break rooms to encourage better eating. They can be as extensive as building fitness facilities onsite or paying for obesity treatments.

A driving factor behind the push toward wellness spans corporations of all types, sizes and cultures: that is, health care expenses are spilling over the corporate belt buckle. The annual cost of medical services in the United States is increasing at seven times the rate of inflation. And the rise in medical costs is one boom pundits expect our economy to sustain.1

This trend makes it increasingly challenging for corporations to maintain current levels of insurance coverage. In 2003, health care inflation forced 65% of corporations to increase workers’ share of health costs.

Seventy-nine% of large firms said they will increase workers’ share of health costs in 2004.2 But with lost benefits and increased financial burdens come lost morale and productivity.

Employers are searching for another way. While corporations cannot control many of the supply-side elements contributing to increasing health care costs—malpractice insurance rates, the nursing shortage—they can help curb demand. That’s why efforts are being redirected from illness to wellness.

The case for Corporate Health Promotion Programs is supported by an ever growing body of evidence demonstrating the high costs associated with controllable health risks:

• One research study reports that obesity raises health care costs by 36% and medication costs by 77%.
• Michigan officials estimate physical inactivity cost the state nearly $8.9 billion in 2002, a cost estimated to be largely borne by corporations through insurance premiums and lost productivity.
• The not-for-profit National Committee for Quality Assurance reports that the estimated average cost for postnatal care for women who did not receive prenatal care was $2,341 more than for women who had. And the indirect costs of unhealthful behavior can be just as high.

Information shows that healthier workers are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier workers use fewer medical services. The five leading causes of death in the United States — heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes — are directly linked to unhealthy lifestyles. Clearly, encouraging healthful habits presents an opportunity to improve workers’ well being, reduce the need for health care services and help control costs.

Offering worker wellness benefits — large or small — represents an intersection between corporate social responsibility and responsibility to stakeholders. Between worker health and corporate health. It’s frequently the right thing to do for workers and corporations.

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Corporate Health Promotion Programs. For many corporations, the choice to offer worker wellness benefits is easy—one where conscience and pragmatism align.

The challenge arises in selecting the initiatives that will deliver the most impact based on trends in your workers’ health risks and medical claims costs. From large corporations to the corner deli, organization owners welcome ways to boost productivity, reduce rates of absence and cut costs. Likewise, Corporate Health Promotion Programs can range from modest to elaborate.

In determining where to focus a organization’s limited resources, looking at benefits, costs and best practices is a good starting point. This section profiles six aspects of wellness and explores their benefits to workers and corporations.

Good for waistlines & your bottom line

By Sandra Simpson, APRN, BC, COHN-S, manager in Occupational Health Services at a Fortune 500 organization in Memphis, Tenn., and a member of the board of directors of the American Association of Occupational Health Nurses (AAOHN). For a copy of the AAOHN wellness survey, visit www.aaohn.org, or call (800) 241-8014, x0.

In today’s hectic world, the majority of of us are spending more time at work, and have increasingly less time to look after our health. For a long time, corporations have understood the benefits associated with keeping workers well – raised productivity from decreased rates of absence and lowered disability claims. For these reasons, coupled with the fact that many corporations realized double-digit health care costs last year, corporations should consider Corporate Health Promotion Programs as a way to keep workers healthy.

But just how important are these initiatives to workers? How frequently are they willing to take part in initiatives designed to positively impact their health and wellness? Who do workers trust to provide them with important information about their health?

Answers to these questions and more were recently garnered from a research study commissioned by the American Association of Occupational Health Nurses Inc. (AAOHN).

The AAOHN survey questioned 500 workers nationwide about their perceptions of Corporate Health Promotion Programs. More than three-quarters of all members indicated these initiatives are a good way to improve their overall health, and nearly 60% consider these offerings an incentive to remain with their current employer. worker retention and turnover impact the bottom line, so building Corporate Health Promotion Programs into the work site culture is a valuable way to help retain talented workers in addition to enhancing personal health and worksite productivity.

The Health wish list

Employees appear to have their own agenda when it comes to their health. With new national security threats, new economic pressures and work/balance issues, it’s not surprising that 85% of survey respondents cited Stress management as a priority topic for work site wellness.

In addition to stress, other preferred topic areas include testing initiatives (84%), exercise/physical fitness initiatives (84%), health insurance education (81%) and disease management lunch and learns (80%).

In addition to lifestyle and personal health issues, those asked expressed concern about work-related health issues, including strains and injuries resulting from lifting or task-oriented muscle repetition, exposure to harmful substances, personal injury, vision changes due to computer work and worksite violence.

What you should do

With such a broad range of health concerns, a primary goal for corporations is finding a way to proactively address the health and wellness needs of the largest number of workers, and effectively change unhealthy behaviors, promote wellness and ward off disease and illness.

Printed materials such as brochures, posters, fliers or pamphlets present an easy solution. But it’s important to remember that different employees require different formats for learning. A good rule of thumb: provide information in a variety of learning formats such as videos, pamphlets, health-related quizzes, display boards, Lunch-and-learn presentations and reimbursement or incentive programs.

This assumes you’ve overcome the first hurdle – getting employees to sign on to a Corporate Health Promotion Program. While survey respondents indicated health and Corporate Health Promotion Programs are important, just six out of 10 (60%) reported that they participated in the Corporate Health Promotion Programs at their corporations. The other 40% cited lack of interest and lack of time as deterrents.

This points to the need for a broad-based, structured Corporate Health Promotion Plan using a innovative approach, with an incentive for participation and effective program marketing.

By investing in an organized Corporate Health Promotion Plan headed by a qualified health care professional such as an worksite nurse, corporations can give workers the access to the health information they want, and increase participation and generate interest at the same time.

The result: workers become savvier health care consumers who feel more in charge of their individual health. And healthier workers make for a healthier bottom line.

Stress continues to drive workers’ work-related health concerns, which is probably why the majority of respondents (78%) in a recently published survey claim they would take part in a Corporate Health Promotion Plan to help their overall health and wellness.

In a recently published research study commissioned by the American Association of Occupational Health Nurses, Inc. (AAOHN), 500 full-time workers nationwide were interviewed telephonically.

“Today’s workers are clearly dealing with a lot of pressures such as the effects of 9/11, an unstable economy, national security threats and work/balance issues. There is a real opportunity for corporations to serve as an ally to their workers by providing them with resources to better manage their physical and emotional health – anything from stress management lunch and learns to nutrition and physical fitness counseling,” says Deborah V. DiBenedetto, president of AAOHN.

Nearly 80% of respondents believe their health would improve if they were offered the right information and tools through a viable Corporate Health Promotion Program.

Topping the list of most interesting Corporate Health Promotion Programs cited by workers is stress management (85%), closely followed by testing initiatives (84%), exercise/physical fitness initiatives (84%), health insurance education (81%) and disease management lunch and learns (80%).

More than half of workers (61%) would rather receive health and wellness information from a health care consultant or worksite nurse, compared to pamphlets or brochures (18%) or human resources staff (15%).

Effective Corporate Health Promotion Programs include the use of data sources in support of Corporate Health Promotion Plan planning, implementation, and evaluation. Information sources can be used to complete a community needs assessment, develop realistic Corporate Health Promotion Plan goals and objectives, and gain Senior Management support.

Centers for Disease Control and Prevention (CDC): Information and statistics
• http://www.cdc.gov/DataStatistics/
• Information and statistics are available by topic (i.e., asthma, injuries, MRSA).
• Information access tools are available to customize information tables and query datasets (i.e., Healthy People DATA2010, tobacco use-Attributable Mortality, Morbidity, and Economic Costs).
• Nationwide survey information is available (i.e., National Health and Nutrition Examination Survey (NHANES)).

CDC Behavioral Risk Factor Surveillance System (BRFSS)
• http://www.cdc.gov/brfss/index.htm
• BRFSS is the world’s largest, ongoing telephone health survey system. BRFSS has been tracking health conditions and risk behaviors in the US yearly since 1984.
• Chronic Disease Indicators are divided into seven categories: physical activity and nutrition, tobacco and alcohol use, cancer, cardiovascular disease, diabetes, overarching conditions, and other disease and risk factors.
• Prevalence information is also available (i.e., weight classification by Body Mass Index and age).

Corporate Health Promotion Plan data collection and analysis is frequently avoided because of a perceived lack of resources for this very important Corporate Health Promotion Plan component. Use the suggestions below to take advantage of a variety of resources available at your company or in the local community.

Medical Interns and Residents
• If your Onsite Medical Center has an internship Corporate Health Promotion Program, get to know the Internship Director.
• Make use of these resources – including having the Director and/or interns/residents begin the outcome information collection plan for your Corporate Health Promotion Program.

Local college and graduate students
• Where appropriate volunteer agreements are in place, use local college/graduate students to help collect, input, and analyze Corporate Health Promotion Plan data.
• Make use of the fact that these students are frequently looking for projects.
• If there are no “health-related” students/interns in your area, consider using organization students. Let them calculate a cost avoidance or return on investment (ROI) for your Corporate Health Promotion Program.

Other Medical Personnel
• Partner with other Medical Personnel. Find out who is collecting information, what information they are collecting, and how they are collecting it.
• If they are using a survey and the survey administration process is already in place, ask if you can add a question or two.
• Be aware of other research going on at your facility. They may already be collecting information you need OR may have analysis resources that can be shared.
• Make sure other departments in the Medical center know you can always use some extra help if they have personnel with any down time. Use these resources for information entry or other administrative tasks.
• Make use of the volunteers to help collect and input data.

Previous Corporate Health Promotion Plan members
• Previous Corporate Health Promotion Plan members are also a good resource.
• They may be willing to lead a class session, provide encouragement to current Corporate Health Promotion Plan members, or help collect data.
You can improve data collection and analysis by taking advantage of local resources. Using these resources expands the reach and impact of your Corporate Health Promotion Program.

A gap analysis is an assessment tool that enables a organization to compare its current capabilities and performance with industry benchmarks and expectations for performance. A gap analysis is used to identify areas that have room for improvement.

Gap analysis can also be used for your Corporate Health Promotion Plan to determine where the program stands now and how the Corporate Health Promotion Plan can better follow evidence-based recommendations.

To start a gap analysis, ask these simple questions about your Corporate Health Promotion Program:
• What is the current state of the Corporate Health Promotion Program?
• How does the Corporate Health Promotion Plan measure up to evidence-based practices? (i.e., the desired state)

The gap is the difference between the current and desired states.

After the gap has been identified, the next step is to determine the action steps that are needed to close the gap. These actions answer the question: “How can the Corporate Health Promotion Plan move forward towards the desired state?”

Sometimes the gaps that need to be filled can be addressed through Corporate Health Promotion Plan changes; other gaps might require policy changes. However, using a gap analysis will help you identify areas for Corporate Health Promotion Plan improvement and the actions needed to make progress towards those goals.

Corporate Health Promotion Plan organization plan review (from Key #19)
• A Corporate Health Promotion Plan organization plan is a roadmap for success.
• Your Corporate Health Promotion Plan organization plan should convincingly demonstrate that your Corporate Health Promotion Plan will help the organization to achieve its goals.

More smart Corporate Health Promotion Plan organization planning strategies

Planning the Corporate Health Promotion Plan
• Find out how your organization plans so that your planning process will be in sync with what already happens in the corporate.
• Involve other employees. A planning team brings their combined experience and perspective to the process. Including potential partners as you plan will make it easier to get their buy-in later.

Thinking of the big picture
• Look at the barriers and challenges that might be encountered during Corporate Health Promotion Plan implementation. Develop strategies ahead of time to overcome these potential problems.
• Do a SWOT analysis and examine Strengths, Weaknesses, Opportunities, and Threats.

This analysis will help you identify potential problem areas or resource shortfalls and opportunities for growth or raised partnerships with other company personnel.

The WORST organization planning strategy: sitting in your office; working by yourself.

The best Corporate Health Promotion Plan organization planning strategies
• Get out of your office; get out of the organization. The more employees you involve in the Corporate Health Promotion Plan planning process, the better. Always look for ways to expand your network.
• Keep your budget employees informed. Get to know their philosophy of financial management.
• Be able to articulate the impact if your budget is not fully funded.
o Avoid basing your impact-if-not-funded argument only on: “We have to.”
o Instead, describe the impact-if-not-funded with phrases like: injuries to workers, raised compensation costs, raised medical care costs for patients, lost work time, loss of licenses/accreditations, loss of workload to the Tricare network.
• Always have purchase requests ready to be submitted. There is frequently a short window of time to process these requests. Having the information gathered ahead of time will make it easy to submit the information right away.

A well thought-out Corporate Health Promotion Plan organization plan is critical in these times of shrinking budgets and resources. A good organization plan will help you gain leadership support and help you get and keep resources needed to begin the Corporate Health Promotion Program.

A organization plan is a roadmap for success. Use the guidelines below to develop a realistic organization plan and budget for your Corporate Health Promotion Programs.

What is a organization plan?
• A plan for success
• A document that convincingly demonstrates that your Corporate Health Promotion Plan will help the company to achieve its goals.

Questions to ask when developing a Corporate Health Promotion Plan organization plan
• Why do you need to do the Corporate Health Promotion Program?
• What are you going to do?
• Where are you going to do it?
• Who is the target audience?
• How are you going to do it?
• Who is going to begin the Corporate Health Promotion Program?
• How much will the Corporate Health Promotion Plan cost Senior Management?
• What is Senior Management going to get out of the Corporate Health Promotion Program? Why should Senior Management invest in the Corporate Health Promotion Program?

Corporate Health Promotion Plan organization Plan Components
• Title and duration of the Corporate Health Promotion Plan
• Points of contact
• Background information (description of need; bibliography/literature review; how the Corporate Health Promotion Plan will help achieve the organization’s goals)
• Corporate Health Promotion Plan description
• Goals and objectives
• Implementation site
• Target population
• Work plan
• Partnerships and collaborations
• Timelines and milestones
• Budget and resource requirements (dollars and employees)

Gaining the support of leadership
• Clearly link the Corporate Health Promotion Plan goals and objectives to the organization’s strategic plan.
• Focus on the desired outcomes.
• Use the right language for the right audience. For example, Senior Management is interested in decreased clinic visits, raised provider productivity, management of the health of the population. However, Senior Management is interested in raised readiness, decreased lost duty/training time, and decreased disability and FECA claims.
A well thought-out Corporate Health Promotion Plan organization plan will help you gain leadership support, help you get and keep resources needed to begin the Corporate Health Promotion Program, and keep the Corporate Health Promotion Plan on track towards meaningful outcomes.

As they say: “timing is everything.” Use the guidelines below to guide the timing of Corporate Health Promotion Plan activities and data collection.

Timing: Corporate Health Promotion Plan Start-up
• Look at the optimal time to start a new Corporate Health Promotion Program. Take into account preferences of the target population and other factors that could affect enrollment and participation.
• For example, coordinating the start of an adult weight management initiative with the start of school in August or September may be a good tie-in with a “fresh start.”
• On the other hand, starting an adult weight management initiative In January may not be a great idea because of the constraints that weather may put on exercising outdoors.
• Make use of other timing cycles at your company. Planning a marketing blitz just after the PCS turnover has been completed is a good way to let new personnel know what Corporate Health Promotion Plan options are available.

Timing: Corporate Health Promotion Plan Participant Support
• Look at how frequently Corporate Health Promotion Plan sessions should be offered to provide the best support and education for members and the best opportunity for success.
• Get feedback from members regarding what session frequencies work best for them.
• Look at the timing for other support mechanisms like email encouragement. What timing of those messages will benefit members most: Weekly? Bi-monthly? Monthly?

Timing: Corporate Health Promotion Plan Data Collection
• Collecting information is an excellent way to track member progress and also to identify potential problems within a Corporate Health Promotion Program. So, give some thought to the frequency and timing of data collection.
• Select metrics that can realistically change during the Corporate Health Promotion Plan implementation time period. For example, BMI and weight may not change very much during a 10-week Corporate Health Promotion Program; however, step counts are more likely to noticeably change.
• Some information, such as member responsiveness to out-of-class assignments (like food journals) and other interim data (like step counts) will provide important information needed to “adjust fire” as needed and make Corporate Health Promotion Plan changes if something is not working.
• Be flexible regarding data collection frequency. Instead of requiring that members complete an physical fitness log every day, for example, consider asking for a “snapshot” summary from two or three days during the week. You will still get information to review, but members will have an easier time complying with the assignment.

Timing: Corporate Health Promotion Plan Follow-up
• Because the we are such a mobile population, it’s best to plan some sort of post-Corporate Health Promotion Program follow-up data collection within two to four months after the Corporate Health Promotion Plan ends.
• You can always try to collect additional follow-up data at 6 or 12 months after Corporate Health Promotion Plan completion. However, if you collect the information sooner, you’ll at least have collected some short term Corporate Health Promotion Plan impact information before members are lost to follow-up.